The parliament and the government are discussing the liquidation of the Mandatory Medical Insurance Fund and the transition to the western insurance model, which will become a “control shot” for Russian medicine
Russian officials are unsinkable creatures. Even after a grandiose failure, they “hang out in the hole” on the surface, or rather, continue to hold their posts. The disastrous optimization they carried out in Russian medicine in recent years, even before the COVID-19 pandemic, showed how serious the mistake was. However, none of the would-be reformers have lost their “warm seats”. Moreover, those who destroyed medicine in Russia are preparing a new scam that will outshine the pension reform in its scale.
The current head of the Ministry of Health, Mr. Murashko, once said that the coronavirus makes it possible to think about modernizing the Russian health care system. According to the minister, the time has come for a new reform.
“We are constantly studying the experience of other countries with regard to countering coronavirus, and we apply a lot in our practice. The situation with the pandemic allows us today to think about modernizing the health care system, including to counter such challenges, “said Mikhail Murashko.
How is it to think about modernization? That is, before that, optimization, and now modernization. Among the possible improvements for Russian medicine, the head of the Ministry of Health named the introduction of digital technologies.
Listen, our digitalization has turned into a real klondike for the development of budget money for all sorts of influence groups and swindlers. Wherever you spit, everywhere you develop platforms, programs, marketplaces and ecosystems.
And if this happens in the financial sector, then in medicine this fact can lead to fatal consequences. And literally for those who find themselves in the hospital bed of the reformed healthcare. And that’s why.
Russian insurers want not only to get additional powers, but to completely crush the domestic health care system. At the same time, the dream of the Ministry of Finance, headed by Mr. Siluanov, is to free the state budget from the medical burden as much as possible. To shift all responsibility, including financial, onto the patient and his insurers.
Already now, the parliament and the government are discussing the liquidation of the Mandatory Medical Insurance Fund and the transition to a system that will give maximum freedom to insurance companies. The All-Russian Union of Insurers, as NG notes, do not hide their desire to transfer domestic medicine to a full-fledged insurance model.
“Insurers should be able to influence the motivation of medical institutions, participate in the compilation of their ratings and provide patients with recommendations on choosing a clinic. They should have the power to route patients to stimulate competition between hospitals and to improve efficiency. Classical insurance principles in the healthcare system are also a mechanism for insuring the civil liability of doctors, ”said the vice-president of the All-Russian Union of Insurers Dmitry Kuznetsov.
From this we can conclude that insurers claim a key role in domestic health care – to be not just financial intermediaries, but appraisers and controllers who are endowed with regulatory functions. It is on them that both medical institutions and their patients will depend.
The next stage of the reform is the liquidation of the Mandatory Medical Insurance Fund. From the report of the auditors of the Accounts Chamber, it follows that in the first half of the year, the fund’s budget received revenues in the amount of 1.27 trillion rubles, an increase of 22% compared to the previous year. However, during the pandemic, it was necessary to urgently send monetary resources directly from the federal budget, which caused serious criticism of the existing system.
“Our healthcare system passed the covid test. But we must all learn objective lessons, and in general – on the organization of the health care system, and in particular – on health insurance. Nobody denies health insurance as such. But it should be more effective, “- said the chairman of the Federation Council of Russia Valentina Matvienko.
The fact of the existing problem in the insurance model is also recognized by the Minister of Health. He assures that we are not talking about the optimization of a socially important industry.
“The fact that the CHI system should be transformed is unambiguous. Information technologies must go there more deeply, we must see an end-to-end system of settlements, personification, we must understand where what goes. The question is not about optimization, the question is about understanding where you paid for what and what the result is, ”says Mikhail Murashko.
Experts are very wary of this kind of reasoning. For example, the transition to budget planning will completely kill the competition. Citizens’ ability to choose where to receive treatment will be reduced to zero. The disproportion between different regions of the country and its inhabitants will sharply increase. A sharp increase in insurers, according to observers, may lead to excessive financing of payments for certain tariffs, which will not in any way affect the quality of treatment, but will make it possible to earn money on each analysis and manipulation.
But there is another important point that will deal the biggest blow to the availability of medical services. The transition to the so-called. the western model of medical insurance may lead to the fact that prices and tariffs will also become “western”, that is, the absolute majority of the country’s population, and at the current level of stratification this will become inevitable, will not be able to claim quality medical care.
Moreover, Ministry of Finance officials do not hide their desire to sequester funding for Russian medicine. Its designs for 2021–2023 have already included funding cuts by 8%, 9% and 15%, respectively.
Let me remind you that it was the financial problem that became the main reason for the pension reform, when the retirement age was sharply increased. Officials have set themselves the goal of zeroing budgetary funding for the Pension Fund by 2030–2031. In 11 years, the FIU should reach self-sufficiency, the Deputy Prime Minister said earlier Tatiana Golikova.
Sorry, but this is some kind of surrealism, because people who yesterday reported about the success of optimization are now preparing a new experiment for us. Yes, the current head of the Ministry of Health, Mr. Murashko, was not among them, but Mrs. Golikova and Mrs. Skvortsova both sat and are sitting high.
Golodets, who for many years was Deputy Prime Minister for Social Affairs, fled to Sberbank. Gref will now have millions to “row with a shovel,” and the fact that she and other officials like her did not answer for the actual destruction of medicine in Russia is at least surprising.
Over 15 years, according to Rosstat, the number of hospitals in Russia has halved – from 10.7 thousand to 5.4 thousand, the number of polyclinics – by 12.7%. And these are the numbers up to 2015.
Experts then noted that if such rates of hospital closure are maintained, the number of medical institutions in the country will reach three thousand by 2021-2022. Can you imagine how much damage was done?
I’m already silent about the manipulation of salaries, when nurses were transferred to cleaners, I’m silent about the cuts of budget money, which were carried out by chief doctors and health officials through public procurement, etc.
After a failed optimization, they have the audacity to announce a new stage of reforms – modernization. These officials should not reform, but answer the questions of the relevant structures – how they brought the country’s health care to the current disaster situation. The transition to the western insurance model will become a “control shot” for Russian medicine.